High Grade B-Cell Lymphoma, NOS

Siba El Hussein, MD
3 min readApr 23, 2022

Lessons From the Friday Unknowns

Bone marrow aspirate smears and the touch imprint show numerous neoplastic cells.

The cells are mostly intermediate-size but a small subset are large. Many neoplastic cells have a distinct or prominent nucleolus. The cells have agranular cytoplasm and a subset of these cells has small cytoplasmic vacuoles. A differential count of a bone marrow smear shows 98% lymphoma cells.

The neoplastic cells are positive for CD5 (weak), CD20 (variable and mostly cytoplasmic), PAX-5, MYC (most cells, strong), BCL-2 (strong), MUM1/IRF4 (weak), TdT (5–10% of cells, weak), and IgD, and are negative for CD3, CD10, CD19, CD34, CD138, BCL-6, cyclin D1 and SOX-11.

The neoplastic cells are negative for Epstein-Barr virus encoded RNA.

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Siba El Hussein, MD
Siba El Hussein, MD

Written by Siba El Hussein, MD

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